Self-help intervention programs have become an important part of the support for people living with the consequences of arthritis; however. the responses of African American women to these intervention programs have not been investigated. The present proposal is designed to better understand the effects of arthritis self-help intervention and how it affects adaptation to arthritis in African American women. The specific intervention program is the Arthritis Self-Help Course (ASHC), designed by a nurse (Lorig 1992). Self-efficacy has been identified as one of the mechanisms by which this program works in increasing adaptation to arthritis. Other potentially mediating factors may be important as well, although how they interact is not clear. The specific aim is to address the questions: (l) What is the effect of the ASHC on arthritis self-efficacy in African American women? (2) What is the relationship of arthritis self-efficacy to perceived social support and spiritual health? Subjects will be 120 African-American women, over age 55, with arthritis. A randomized pretest-posttest design will be used to investigate differences in self-efficacy in ASHC participants and a control group. The relationship of social support and spiritual well-being to self-efficacy will also be investigated. Instruments to be administered are: Demographic Data Sheet, Arthritis Self-Efficacy Scale, Personal Resource Questionnaire, and the Spiritual Well-Being Scale. Subjects will be randomly assigned to a control or treatment group. The treatment group will participate in the ASHC. The control group will be offered the opportunity to take the Course after the study period. It is hypothesized that participants in the ASHC will show increased adaptation to arthritis as measured by increased self-efficacy for management of pain and other symptoms. If increases in self-efficacy are linked to social support and spiritual health, this theory based study could add to the existing knowledge of how self-help intervention works. Additional answers to the question of the generalizability of self- efficacy in minority populations may result from this study. It should provide the basis for future research on providing more effective racially and ethnically relevant care to minority women with arthritis.